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Characteristic diffusion tensor tractography in multiple system atrophy with predominant cerebellar ataxia and cortical cerebellar atrophy

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Abstract

The objective of this study is to determine whether diffusion tensor imaging (DTI) tractography analysis is a potential method for differentiating cerebellar ataxia patients with multiple system atrophy with predominant cerebellar ataxia (MSA-C) and cortical cerebellar atrophy (CCA). Forty-one MSA-C patients (62.7 ± 8.1 years old, mean ± SD) and age- and gender-matched 15 CCA patients (63.0 ± 8.6 years old) were examined. Tractography was performed using the DTI track module provided in the MedINRIA version 1.9.4, and regions of interest were drawn manually to reconstruct an efferent fiber tract and two afferent fiber tracts via the cerebellum. Compared with CCA, MSA-C patients showed significant declines of fractional anisotropy (FA) values of afferent 1 and 2 (p < 0.01, respectively) and a significant increase of the radial diffusivity (RD) value in afferent 1 (p < 0.05). Receiver-operator characteristic curve analysis showed 85.7 % sensitivity and 75.0 % specificity of FA values in afferent 1 (cutoff value 0.476). Linear regressions showed strong correlations between FA value and disease duration in CCA patients (efferent 1, r = −0.466; afferent 2, r = −0.543; both p < 0.05), and between the FA value and the ratio of the standardized scale for the assessment and rating of ataxia (SARA)/disease duration in MSA-C patients (afferent 1, r = −0.407; p < 0.01). The present DTI tractography newly showed that the FA values of two afferent fiber tracts showed significant declines in MSA-C patients, and afferent 1 showed good diagnostic sensitivity and specificity. When combining the FA values of efferent 1 with disease duration, the present DTI tractography analysis could be useful for differentiating MSA-C and CCA patients.

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Acknowledgments

This work was partly supported by Grants-in-Aid for Scientific Research (B) 25293202, (C) 15K09316 and Challenging Research 15K15527 and Young Research 15K21181, and by Grants-in-Aid from the Research Committees (Mizusawa H, Nakashima K, Nishizawa M, Sasaki H, and Aoki M) from the Ministry of Health, Labour and Welfare of Japan.

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Authors and Affiliations

  1. Department of Neurology, Graduate School of Medicine, Dentistry and Pharmacy, Okayama University, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan

    Yusuke Fukui, Nozomi Hishikawa, Kota Sato, Yumiko Nakano, Ryuta Morihara, Yasuyuki Ohta, Toru Yamashita & Koji Abe

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  1. Yusuke Fukui
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  2. Nozomi Hishikawa
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  3. Kota Sato
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  4. Yumiko Nakano
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  5. Ryuta Morihara
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  6. Yasuyuki Ohta
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  7. Toru Yamashita
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  8. Koji Abe
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Correspondence to Koji Abe.

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The authors declare no financial or other conflict of interest.

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Ethical permission for this study was provided by the Ethics Committee on Epidemiological Studies of the Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences (Approval #304), and written informed consent was obtained from all participants prior to enrollment in this study.

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Fukui, Y., Hishikawa, N., Sato, K. et al. Characteristic diffusion tensor tractography in multiple system atrophy with predominant cerebellar ataxia and cortical cerebellar atrophy. J Neurol 263, 61–67 (2016). https://doi.org/10.1007/s00415-015-7934-x

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  • DOI: https://doi.org/10.1007/s00415-015-7934-x

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